Hearing loss is one of the most common service-connected disabilities and may have a significant impact on quality of life and health. Comprehensive hearing health services mandate tailored treatments offered for individuals based on degree of hearing loss and patient preferences. The VA is the ideal setting to study management of severe hearing loss as this is a prevalent condition among veterans and data from the Audiometric Repository is available to allow identification of patient, system and provider factors associated with receipt of particular treatment strategies. A sequential explanatory design using interviews will be conducted with various stakeholders including Veterans and providers. Results from this pilot will provide new information on barriers and facilitators of management of severe hearing loss. Educational materials will be developed to develop and test an implementation approach to achieve best practices in the treatment of severe hearing loss.